The exam form
The examiner uses VA's "Initial Post Traumatic Stress Disorder (PTSD)" form. VA keeps this form for its own examiners and doesn't publish it, so this page describes the exam from VA's rules and its public information.
What the exam is for
The exam helps VA decide whether you have PTSD, whether it's linked to an event in service (a stressor), and how much it affects your work and relationships.
Who does it
For a first PTSD exam, a psychiatrist or psychologist does it, either at VA or with one of VA's exam contractors. VA keeps the first-exam form for its own examiners. Later "review" exams use a public form, the Review PTSD form on VA.gov. That form shows the kinds of questions both exams cover.
If you need a break, tell the examiner. If you're in crisis during or after the exam, call 988 and press 1.
What the examiner will ask and measure
- Your life before, during and after service: family, school, work, relationships.
- The event or events in service, and what happened afterward.
- Your symptoms, checked against the medical definition of PTSD: memories, nightmares or flashbacks you don't want; avoiding reminders; changes in mood or thinking, such as guilt, blame, or feeling cut off from people; and being on edge, such as anger, startling easily, or trouble sleeping or concentrating.
- A checklist of 31 symptoms VA uses for ratings, such as panic attacks, sleep problems, memory problems, trouble at work, and thoughts of suicide.
- Treatment, medicines, alcohol or drug use, and any trouble with the law.
- Whether you can manage your own money.
Be ready to describe
- What happened in service, as much as you're able to share. You don't have to share more detail than you can. You can tell the examiner you need a break.
- How your symptoms show up in daily life, with real examples: how often you have nightmares, how you sleep, what happens at work, how you get along with family.
- Your worst weeks, not only how you feel today.
- Treatment, counseling and medicines, and their side effects.
- Changes others have noticed. A statement from a family member or friend (on VA Form 21-10210) can help show this.
Common mistakes
- Saying "I'm fine" or "I manage" out of habit, when that isn't the whole story.
- Describing only a good day. Tell the examiner about the bad days too, and how often they happen.
- Leaving out things that feel embarrassing, like losing a job, angry outbursts, or drinking to sleep. Examiners hear these things often.
- Not mentioning thoughts of hurting yourself. The examiner needs to know, and help is available.
How VA rates it
VA rates PTSD, like other mental health conditions, on one scale: the General Rating Formula for Mental Disorders. It looks at how much your symptoms get in the way of work and relationships (occupational and social impairment). VA proposed a new mental health rating scale in February 2022 (87 FR 8498). As of October 2026 it isn't final, so the current scale still applies.
In plain English
- 100%: Total impairment at work and in social life. Examples of symptoms: a breakdown in thinking or communication; ongoing delusions or hallucinations; very inappropriate behavior; a constant danger of hurting yourself or others; being unable at times to handle basic daily care or hygiene; not knowing the time or place; forgetting the names of close family, your job or your own name.
- 70%: Problems in most areas of life, such as work, school, family, judgment, thinking or mood. Examples of symptoms: thoughts of suicide; rituals that get in the way of daily life; speech that at times doesn't make sense; near-constant panic or depression that affects your ability to function on your own; poor impulse control, such as unprovoked irritability with periods of violence; getting disoriented in space; neglecting your appearance and hygiene; trouble handling stress, including at work; being unable to keep up relationships.
- 50%: Reduced reliability and productivity at work and in social life. Examples of symptoms: a flat mood; roundabout or repetitive speech; panic attacks more than once a week; trouble understanding complex instructions; memory problems, such as forgetting to finish tasks; poor judgment; trouble with abstract thinking; problems with motivation and mood; trouble building and keeping work and social relationships.
- 30%: Occasional drops in how well you work, and times when you can't do your job tasks. You still mostly get by, with normal routine, self-care and conversation. Examples of symptoms: depressed mood; anxiety; suspiciousness; panic attacks once a week or less; ongoing sleep problems; mild memory loss, such as forgetting names, directions or recent events.
- 10%: Mild or short-lived symptoms that affect work only during times of significant stress. Or symptoms that daily medicine controls.
- 0%: A diagnosed condition. Its symptoms don't interfere with work or social life, and it doesn't need daily medicine.
- The symptoms listed are examples. VA looks at how all of your symptoms affect your work and social life.
The regulation, word for word
Quoted from 38 CFR Part 4 (current as of October 16, 2026). This is what VA applies. The plain-English version above is our summary of it.
VA rates this code with the formula below.
General Rating Formula for Mental Disorders
| Criteria | Rating |
|---|
| Total occupational and social impairment, due to such symptoms as: gross impairment in thought processes or communication; persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger of hurting self or others; intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene); disorientation to time or place; memory loss for names of close relatives, own occupation, or own name. | 100 |
| Occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood, due to such symptoms as: suicidal ideation; obsessional rituals which interfere with routine activities; speech intermittently illogical, obscure, or irrelevant; near-continuous panic or depression affecting the ability to function independently, appropriately and effectively; impaired impulse control (such as unprovoked irritability with periods of violence); spatial disorientation; neglect of personal appearance and hygiene; difficulty in adapting to stressful circumstances (including work or a worklike setting); inability to establish and maintain effective relationships. | 70 |
| Occupational and social impairment with reduced reliability and productivity due to such symptoms as: flattened affect; circumstantial, circumlocutory, or stereotyped speech; panic attacks more than once a week; difficulty in understanding complex commands; impairment of short- and long-term memory (e.g., retention of only highly learned material, forgetting to complete tasks); impaired judgment; impaired abstract thinking; disturbances of motivation and mood; difficulty in establishing and maintaining effective work and social relationships. | 50 |
| Occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks (although generally functioning satisfactorily, with routine behavior, self-care, and conversation normal), due to such symptoms as: depressed mood, anxiety, suspiciousness, panic attacks (weekly or less often), chronic sleep impairment, mild memory loss (such as forgetting names, directions, recent events). | 30 |
| Occupational and social impairment due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during periods of significant stress, or symptoms controlled by continuous medication. | 10 |
| A mental condition has been formally diagnosed, but symptoms are not severe enough either to interfere with occupational and social functioning or to require continuous medication. | 0 |
Related
About every C&P exam
What is it?
After you file a claim, VA may ask you to have a claim exam, also called a compensation and pension (C&P) exam. It helps VA decide whether your condition is connected to your service, and how severe it is. It isn't treatment: the examiner won't treat you, prescribe medicine or refer you to anyone.
Who does it?
A VA provider or a provider from one of VA's exam contractors (Loyal Source, OptumServe, QTC or VES). VA picks; you can't choose. Hearing, mental health, eye and dental exams are done by specialists. For a reproductive, breast, rectal or mental health exam, or a claim related to military sexual trauma, you can ask for a male or female examiner.
How long does it take?
VA says anywhere from 15 minutes to an hour or more, depending on what you claimed. Some exams are by phone or video. If you claimed more than one condition, VA tries to schedule them on the same day.
Does the examiner decide my claim?
No. The examiner writes a report on a standard form (a Disability Benefits Questionnaire, or DBQ) and sends it to VA. VA decides your claim using all the evidence: the report, your medical and service records, and statements from you and others. The examiner can't tell you the results or answer questions about your claim.
Does everyone get one?
No. If your records already have what VA needs, VA can decide from the records alone (VA calls this Acceptable Clinical Evidence, or ACE).
What if I can't make it?
Call the number on your appointment letter at least 48 hours ahead to reschedule. Missing an exam delays your claim. VA may decide your claim on the evidence it already has, and some claims, such as a claim for an increase, are denied (38 CFR 3.655). If you had a good reason, such as being in the hospital or a death in your family, tell VA and ask for a new exam.
What should I bring?
VA says you don't need to bring anything. Send any new medical records to VA before the exam, because the examiner can't send them in for you. Arrive 15 minutes early and wear clothes you can move in. Many veterans find it helps to bring a short list of their symptoms, medicines and side effects, and key dates, so nothing is forgotten.
Can someone come with me?
You can ask the examiner. They may ask family members or caregivers to wait outside. For a sensitive physical exam, you can ask for a chaperone in the room.
Can I get a copy of the report?
Yes. Ask VA with a Freedom of Information Act or Privacy Act request (VA Form 20-10206). VetEZ Claim can help you fill it out and send it.
Can my own doctor fill out the form instead?
For many conditions, yes. VA publishes the exam forms (DBQs) your own doctor can fill out and you can send in. VA doesn't pay for this. A few exam forms are for VA's own examiners.
Checked against VA's forms and rules on October 16, 2026. General information only, not medical or legal advice about your claim. VA decides every claim.
